What is Pneumothorax?

It is defined as a collection of gas in the pleural space that results in the complete or partial collapse of the lung. Normally the pressure in the normal pleural sac is sub-atmospheric. With the leakage of air into the pleural space, the pressure approaches atmospheric, which leads to the collapse of the lung. If the pressure in a pneumothorax rises above atmospheric as may occur in a one way (ball valve) leak into the pleural space, a tension pneumothorax is present. This is an emergency.

Causes

1. Penetrating injury.
2. Rib fracture.
3. Lung diseases eg emphysema, asthma, tuberculosis, lung abscess, rupture of congenital cysts.

Clinical Features

1. Acute chest pain.
2. Breathlessness.
3. Dry hacking cough
4. Collapse, shock.

Management

1. Immediate evacuation to a hospital.
2. Patient is not to be moved in an unpressurised aircraft because the decrease in atmospheric pressure may enlarge the pneumothorax and this may seriously compromise lung and heart function.
3. In an emergency, air needs to be drained out rapidly by means of a need.

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